Individual
JENNIFER WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
32 CRESCENT ST, KINGSTON, MA 02364-2255
(508) 747-2012
Mailing address
32 CRESCENT ST, KINGSTON, MA 02364-2255
(508) 747-2012
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
05/13/2014
Last updated
05/13/2014
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